Search Results for "acupuncture"

Mar 31 2014

Acupuncture – Science as Promotion

Almost weekly I see a new press release about an acupuncture study claiming benefits. While I have written extensively about acupuncture previously, and will continue to cover the topic, I can’t cover every little study that comes out. Most of the studies are utterly useless – they contain no control group, they are effectively pilot studies, they are of “electroacupuncture” (which is really just transdermal electrical nerve stimulation pretending to be acupuncture), or they are looking at some dubious biomarker rather than objective clinical outcomes.

Occasionally, however, an acupuncture study deserves a mention, in this case because it is particularly abusive.

Rachael Dunlop, my skeptical colleague from down under, sent me a report of an acupuncture study performed in Melbourne. News outlets are reporting the study at face value, in typical gushing terms, stating that “acupuncture is just as effective as drugs in treating back pain and migraine.”

It seems to me that this is the actual purpose of such studies – to produce positive news coverage. They are not designed to actually answer the question of efficacy.

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164 responses so far

Feb 13 2014

P-Hacking and Other Statistical Sins

Published by under General Science

I love learning new terms that precisely capture important concepts. A recent article in Nature magazine by Regina Nuzzo reviews all the current woes with statistical analysis in scientific papers. I have covered most of the topics here over the years, but the Nature article in an excellent review. It also taught be a new term – P-hacking, which is essentially working the data until you reach the goal of a P-value of 0.05. .

The Problem

In a word, the big problem with the way statistical analysis is often done today is the dreaded P-value. The P-value is just one way to look at scientific data. It first assumes a specific null-hypothesis (such as, there is no correlation between these two variables) and then asks, what is the probability that the data would be at least as extreme as it is if the null-hypothesis were true? A P-value of 0.05 (a typical threshold for being considered “significant”) indicates a 5% probability that the data is due to chance, rather than a real effect.

Except – that’s not actually true. That is how most people interpret the P-value, but that is not what it says. The reason is that P-values do not consider many other important variables, like prior probability, effect size, confidence intervals, and alternative hypotheses. For example, if we ask – what is the probability of a new fresh set of data replicating the results of a study with a P-value of 0.05, we get a very different answer. Nuzzo reports:
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62 responses so far

Nov 14 2013

Is There a Pseudoscience Event Horizon?

Earlier this week Massimo Pigliucci over at Rationally Speaking wrote an intriguing blog post asking whether or not there is a pseudoscience black hole – a point beyond which a pseudoscience gets sucked in and can never escape? Asked from the other direction – are there any historical examples of a pseudoscience that became legitimate, essentially turned out to be true?

I thought this was an interesting enough question to pick up the ball and explore the question further.

First, the question requires a discussion of what is pseudoscience. This is a common topic of discussion among skeptics. Any definition must contend with the demarcation problem – there is no bright line between legitimate science and pseudoscience. Rather, there is a smooth continuum, although I do think the distribution along that continuum is bimodal.

The differences between science and pseudoscience have to do with process, not subject matter. Pseudoscientists display a number of typical behaviors  (I will quickly list some of them here, but I am overdo for an updated post just on this topic):

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74 responses so far

Oct 04 2013

CAM Research – Be Careful What You Wish For

Edzard Ernst is the first professor of complementary and alternative medicine (CAM). He began 20 years ago as a CAM enthusiast, and a trained homeopath, and genuinely wanted to point the critical eye of science onto CAM. Many CAM proponents claim this, but Ernst was different in a key respect – he wanted to use rigorous scientific research to find out if CAM worked, not to prove that it does.

He recently wrote about his 20 years of CAM research, and eloquently makes this point. He writes:

Unfortunately, we also had a few co-workers who, despite of our best efforts, proved to be unable of critical thinking, and more than once this created unrest, tension and trouble. When I analyse these cases in retrospect, I realise how quasi-religious belief  must inevitably get in the way of good science. If a person is deeply convinced about the value of his/her particular alternative therapy and thus decides to become a researcher in order to prove his/her point, serious problems are unavoidable.

Problems are indeed unavoidable. There is a problem with researcher bias and publication bias in medical research. Science magazine also reports on a “sting” operation in which an author submitted a hopelessly flawed paper to 304 open access journals, with more than half accepting the paper for publication. There are plenty of places to publish terrible research that proves whatever point you wish to make.

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7 responses so far

Sep 26 2013

The Pharma Shill Gambit and Other Nonsense

Those of us who have been writing about science and medicine for a few years or more quickly experience the fact that there is a subculture of people who are greatly hostile to our message. In addition, they tend to use the same fallacious arguments against us over and over again, as if they are reading from the same script.

As a result we answer the same bad arguments repeatedly, at least so that those who are paying attention will be more prepared to deal with such arguments themselves. Earlier this week Harriet Hall wrote an excellent post over at Science-Based Medicine in which she answers 30 common fallacious arguments against SBM.  The next day I received a comment here that parroted some of the same arguments yet again.

I have addressed these common anti-SBM arguments multiple times, mostly in piecemeal, so it’s good to have Harriet’s post as a sort-of SBM FAQ. Before you leave a critical comment, read the FAQ.

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28 responses so far

Sep 24 2013

Misinformation from Mayo Clinic

The Mayo Clinic is a recognized center for excellence in both clinical medicine and research. They also maintain one of the best medical information websites on the net. I often find myself there when searching for information on a topic with which I am not familiar.

The Mayo Clinic also represents the current problem with academic medicine and the current fad of so-called complementary and alternative medicine (CAM) – they just don’t get it. They do not seem to understand what CAM really is, its history,  its current practice, and the state of the evidence. But they know it’s out there and people are interested in it (because they are told they should be) and so they feel the need to address it.

When they do address CAM, however, they have apparently done what most academic centers have done in my experience – they turn it over to “CAM experts,” which ends up being CAM proponents. The result is that CAM propaganda and shameless promotion becomes endorsed by an academic institution (what my colleagues and I have come to call “quackademic medicine”).

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22 responses so far

Sep 03 2013

The 1996 WHO Acupuncture Report

One interesting effects of social media is that news items can have a second life – someone posts an item from years ago on their Facebook page, for example, and it makes the rounds as if it’s something new. Those of us who spend time analyzing science news reports and correcting misreporting or misleading information often refers to such items as zombies. They keep rising from the dead and have to be staked all over again.

The World Health Organization (WHO) 1996 report on acupuncture has recently risen from the grave and is haunting online acupuncture discussions. The fact that the data on which this report is based is over 17 years out of date does not seem to be a problem for those referencing it. The allure seems to be the apparent authority of the WHO.

The WHO report is generally positive toward acupuncture, reviewing clinical evidence and listing many conditions for which acupuncture is apparently effective. The report, however, is also deeply flawed.

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6 responses so far

Sep 02 2013

TCM for Flu

A recent new report exposes Chinese health officials for recommending worthless and unscientific remedies for the flu. Chinese doctors have been leveling the criticisms, pointing out that the recommended Traditional Chinese Medicine (TCM) treatments are not supported by evidence.

TCM has had a rocky road in China. By the first half of the 20th century it was on the wane, at least in the cities, where “western” scientific medicine was taking hold. It’s possible that if this trend had continued, then TCM would have gone the way of humoral medicine and blood letting in the West – replaced by modern medicine.

Mao Zedong had a huge role to play in history taking a different course. He was trying to modernize China under communist rule.  Part of his plan was to merge TCM with modern scientific medicine, thereby keeping the cultural roots of China, but meeting his agenda of modernizing.

The real boost to TCM, however, came from the barefoot doctor program. This program, which was actually a good idea, was designed to meet the medical needs of the hundreds of millions of citizens who did not live in the cities. They could not train enough doctors to meet this need, so they trained hundreds of thousands of farmers to be doctors and paramedics. They were given 6-9 months of training, then sent back to their villages and farms to provide needed medical care.

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3 responses so far

Mar 25 2013

Debating Homeopathy Part I

Six years ago I was asked to participate in a group debate over the legitimacy of homeopathy at the University of CT (there were six speakers, three on each side). This year I was asked to participate in another homeopathy debate at UCONN, but this time one-on-one with Andre Saine ND from the Canadian Academy of Homeopathy taking the pro-homeopathy side. (I will provide a link when the video is posted online.)

While the basic facts of homeopathy have not changed in the past six years, the details and some of the specific arguments of the homeopaths have evolved, so it was good to get updated on what they are saying today. In this post I will discuss some overall patterns in the logic used to defend homeopathy and then discuss the debate over plausibility. In tomorrow’s post I will then discuss the clinical evidence, with some final overall analysis.

Believers and Skeptics

As with the last debate, the audience this time was packed with homeopaths and homeopathy proponents. When I was introduced as the president of the New England Skeptical Society, in fact, laughter erupted from the audience. But that’s alright – I like a challenge. It did not surprise me that the audience, and my opponent, were unfamiliar with basic skeptical principles. Andre, in fact, used the word “skeptic” as a pejorative throughout his presentation.

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46 responses so far

Mar 12 2013

Another Acupuncture Meta-Analysis – Low Back Pain

As Carl Sagan observed, “randomness is clumpy,” which means that sometimes, for no specific reason, I write two or more blog posts in a row about the same topic. Perhaps it’s not entirely random, meaning that when a topic is being discussed related news items are more likely to come to my attention.

In any case, there was recently published yet another meta-analysis of acupuncture, this time specifically for low back pain. The findings and interpretation add to the pile of evidence for two important conclusions:

1 – Acupuncture does not work.

2- Acupuncturists refuse to admit that acupuncture does not work.

I would further infer from these two unavoidable conclusions the dire need for a greater understanding of the core principles of science-based medicine.

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60 responses so far

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